Association of Chlamydia pneumoniae with atherosclerosis: The evidence

Abstract

An association between chlamydial infection and vascular disease was first described about 60 years ago. In the 1940s, South America investigators observed that the intradermal Frei test (which measures hypersensitivity to all chlamydial species) was positive not only in patients with lymphogranuloma venerum, but often also in patients with arteriosclerosis. At the time, these observations went largely unacknowledged, possibly because they were published only in Spanish. It is now clear that all chlamydial species can cause endocarditis, myocarditis or pericarditis. In addition, evidence accumulated since the late 1980s from seroepidemiological, pathological and animal studies suggests that Chlamydia pneumoniae may have a direct role in the development or progression of atherosclerosis and, in particular, coronary heart disease (CHD).